Cocaine abuse is a major public health problem with enormous personal and societal costs. The need for treatments that are both effective and cost-effective is clear and compelling. The present proposal seeks to evaluate the relative effectiveness and cost-effectiveness of three, promising psychosocial treatments for cocaine abuse: (1) Supportive-Expressive psychotherapy plus drug counseling (2) Cognitive-Behavioral psychotherapy plus drug counseling, and (3) Drug Counseling alone provided by two counselors. At each of four Collaborative Treatment Sites, 90 medication-free, cocaine-dependent outpatients, of varying levels of psychiatric severity, with and without antisocial personality disorder, will be randomly assigned to one of the three treatment conditions and followed prospectively for two years. Treatment outcome will be evaluated at regular intervals, using a comprehensive and multifaceted assessment battery. Concurrently, data on law enforcement, employment, family burden, and treatment costs will be obtained. These will be combined with the treatment efficacy data and with data on outcome utilities representing a variety of perspectives. The cost-effectiveness and cost-utility of the three treatment then will be compared..
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